Achalasia

Overview

Achalasia is a swallowing condition that affects the tube connecting the mouth and the stomach, called the esophagus. Damaged nerves make it hard for the muscles of the esophagus to squeeze food and liquid into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth. This fermented food can taste bitter.

Achalasia is a fairly rare condition. Some people mistake it for gastroesophageal reflux disease (GERD). However, in achalasia, the food is coming from the esophagus. In GERD, the material comes from the stomach.

There's no cure for achalasia. Once the esophagus is damaged, the muscles cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.

Symptoms

Achalasia symptoms generally appear gradually and get worse over time. Symptoms may include:

• Difficulty swallowing, called dysphagia, which may feel like food or drink is stuck in the throat.
• Swallowed food or saliva flowing back into the throat.
• Heartburn.
• Belching.
• Chest pain that comes and goes.
• Coughing at night.
• Pneumonia from getting food in the lungs.
• Weight loss.
• Vomiting.

Causes

The exact cause of achalasia is poorly understood. Researchers suspect that it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses are possibilities. Very rarely, achalasia may be caused by an inherited genetic disorder or infection.

Risk factors

Risk factors for achalasia include:

• Age. Although achalasia can affect people of all ages, it's more common in people between 25 and 60 years of age.
• Certain medical conditions. The risk of achalasia is higher in people with allergic disorders, adrenal insufficiency or Allgrove syndrome, a rare autosomal recessive genetic condition.